Leg Veins

Advanced Dermatology offers its North Shore and Chicago patients leg vein solutions led by Dr. David Ian Rosen, one of only 520 physicians in the nation who is board-certified in phlebology, a medical specialty focused on solely treating leg vein diseases.

Spider and Varicose Veins affect about 45% of adults in the US! For some of us it is the unsightliness of the red and purple veins that make us feel self-conscious about wearing shorts and skirts. For others it is a constant struggle with heavy-feeling legs, swelling, easy fatigue and/or outright pain.

Varicose veins are often caused by abnormalities of underlying valves that need to be corrected. To determine whether abnormal valves are the cause, we perform a duplex ultrasound scan that is non-invasive and usually covered by most insurance companies (after deductible is met- you must confirm with your individual policy).  If there are detectable valvular abnormalities, a very common finding, you will then potentially be fortunate enough to qualify for an endovenous laser treatment, an outpatient procedure that can correct the abnormal valves.  This can lead to resolution of symptoms, as well as much of the appearance of the larger veins.  Sclerotherapy, and sometimes laser treatments, are used for the spider veins that are not connected to abnormal valves, or the remainder of veins appearing for what is left over after we have completed repairing the valves.

Commonly Asked Questions on Laser Leg Vein Removal and Sclerotherapy

What is Laser Leg Vein Removal and Sclerotherapy?

Laser Leg Vein treatments enable removal of unwanted small and large spider veins in a few treatments.  We use our knowledge of anatomy and plan treatments carefully to ensure the best cosmetic outcome.  We utilize both the most effect laser technology for this purpose as well as the time honored practice of injection sclerotherapy. 

Laser Leg Vein treatments are laser treatments and sclerotherapy is an injectable therapy used to remove spider and reticular veins.

During a Laser Leg Vein treatment, your provider will apply ultrasound gel to the area being treated.  The laser is then applied in “pulses” to the entire area.  Cool air is blown on the area during the treatment to minimize discomfort and prevent side effects.  Depending on the extent of the veins, each treatment takes between 15-60 minutes.  Subsequent treatments are performed at 4 to 12 week intervals. 

Injection sclerotherapy is a technique where a solution is injected in the veins to cause their removal by the body.  This procedure does require needles but is actually quite tolerable. 

How do I know if I need Laser Leg Vein treatments?

A candidate for Laser Leg Vein treatments is anyone who has leg veins that are less than 5mm in size, that understands the risks, costs, and time necessary to achieve the full benefit of the procedure, who has realistic expectations of the ultimate outcome. 

If you have an underlying problem with the deeper valves in your veins, or veins that are larger than 5mm, you may not be a good candidate.  This can be determined during your consultation.

If you are pregnant, take aspirin or other blood thinning medications, or have a medical condition that prevents your blood from clotting properly, you should not have this procedure. 

What type of equipment is used?

To treat leg veins, we use 1064nm (CoolGlide® Vantage by Cutera®) or a diode 900nm with radiofrequency (Polaris™ LV by Syneron™) laser.

We use FDA approved Sotradecol solution and sterile needles for injection sclerotherapy.

What desired results can be expected?

Lasers are machines that produce a beam of light that has a specific biological target.  Some lasers target blood vessels and are absorbed by these.  The laser light is then absorbed by hemoglobin, a substance in the blood that gives it a red or purple color.  This heats up the blood vessel enough for the vessel to be heat sealed or damaged.  Over time the body reabsorbs these damaged vessels.

Sclerotherapy instills a chemical into the vein that makes it sclerose, which means close and be reabsorbed by the body.  It is similar in practice to laser treatments but uses the chemical solution to perform the work rather than light.

If a vein goes completely away with treatment, it should not return, but occasionally the body reopens the vessel before it is completely reabsorbed or the vessel only partially responds.  Because of this we find that most people need 2-6 treatments that are 4-12 weeks apart.  Also the factors that contributed to the enlarged veins such as standing for long periods of time, female hormones, pregnancy, being overweight, or a family history of varicose veins may not change, and therefore, new veins tend to form over time.

Are there any negatives?

With the laser treatments, there is some discomfort during the procedure that we try to minimize with cold air and massage.  After the procedure is over, there is no discomfort.

With sclerotherapy, there are a few small needle marks that resolve over a couple of days and minimal discomfort.

The veins treated will usually look darker and a bit swollen after the procedure.  There may be small pink bumps that resemble mosquito bites that can last a day or two.  We recommend wearing medical grade support stockings for at least three days after the procedure to alleviate these symptoms.

When we target larger veins it is possible that a small amount of blood can “leak” out of the vessel before it is heal-sealed resulting in a bruise or discoloration of the skin.  Bruises are temporary and resolve in 1-2 weeks.  The risk increases if you take aspirin products or are on blood thinners.  Because blood contains iron, it is possible for a brownish discoloration to result.  This is usually temporary but can occasionally last for many months.  We can also use photorejuvenation treatments to fade the area.

Uncommonly, a skin wound such as superficial blisters and scabs can occur, which heal within 2 days to 14 days.  Use of antibiotic ointment on a regular basis usually results in uneventful healing.  There is a <0.5% possibility of a skin wound leaving behind a scar.  It is also rare for an injection to occur since the skin is usually not broken.

With foam sclerotherapy there is a rare possibility of having temporary “scotoma” which is like seeing spots before your eyes or feeling slightly light-headed.  This occurs in less than 1 in 10,000 injections.  If you have a known patent oval foramen (“hole” in your heart) we may choose to limit your treatments as this is a known risk factor.  

What happens after Laser Leg Vein Removal and Sclerotherapy?

You may go directly back to work or your regular activities after a procedure.  In most cases we recommend wearing medical grade support stockings for a minimum of three days after a procedure.  You should avoid strenuous exercise, alcohol, and aspirin products for 48 hours following the procedure.

Is there another way to get the same effect?

Alternatives to treatment of leg veins include surgical vein removal and ambulatory phlebectomy.

Both laser and sclerotherapy are effective treatments for leg veins, but laser has some advantages over sclerotherapy.  We are also able to effectively treat small vessels which can sometimes be difficult to do with sclerotherapy.  Laser allows us to treat leg veins around the ankles that could not be treated with injections.  We are also able to address the underlying larger veins and source of spider veins with laser that is more effective.

Sclerotherapy has its advantages that the solution travels all along the vein and also to tributaries so no all of the vein needs to be injected, so it is a bit faster.  Sclerotherapy is less expensive due to the lower cost of equipment.  Finally sclerotherapy works a bit faster than laser.

Because we do both, we try to take advantage of both while trying to minimize the negatives of each and give you the best of both treatments.

Ambulatory phlebectomy physically removes the vein.  Therefore no needles or lasers are needed and there is a complete removal immediately.  However, you require anesthesia and you will have some very small marks left behind where the skin was entered to remove the vein.

Can this be combined with other treatments?

Laser Leg Vein treatments and Sclerotherapy can be combined with any of our other cosmetic services.

How much does Laser Leg Vein Removal and Sclerotherapy Cost?

The fees for Laser Leg Vein treatments and Sclerotherapy depend on the extent of your leg veins.  To learn more about laser leg vein removal, please call 847-459-6400 or contact us to make an appointment with one of our cosmetic coordinators.